5 considerations for medically fragile students in school

Discussion points for school teams and parents should include how supports will be delivered with social distancing protocols, a possible mask exemption, nurse's office protocols, COVID fears, and possible remote learning instead of a return to the school building.

School districts should keep an open dialogue with parents of medically fragile students about school attendance this fall, says Maria B. Desautelle, a school attorney at Sweet, Stevens, Katz & Williams LLP in New Britain, Pa.

If the student will attend in-person instruction at school, here are a few issues to include in your discussion:

1. Delivering supports. How you will provide the student’s supports will depend on whether you can maintain social distancing requirements and still meet the student’s needs, Desautelle says. There are situations where the student’s needs will take priority over social distancing requirements.

“It’s difficult to give an example without a specific scenario and without knowing a student’s individual needs, but in general, one-to-one nursing services would be an exception to social distancing requirements,” Desautelle says. “It would be difficult to administer many nursing services from a distance.”

2. Mask exemptions. Masks are required unless the student has medical documentation that indicates he can’t wear one, Desautelle says. In some cases, it will be obvious that a student can’t wear a mask. In others, the district may need to consult with the student’s physician for the reason why the student can’t wear a mask.

Identify whether the student has a reason she is unable to wear a mask or if her parents just prefer that she doesn’t. “I don’t think anyone prefers to wear a mask, so it’s a delicate balancing act,” she says. “You don’t want to jeopardize any medical conditions, but you have to take a close look at that because [there are] reasons why in the school setting people are wearing them.”

3. Protocols in the nurse’s office. Visits to the nurse’s office might look at little different. “Look at scheduling more carefully to make sure you have a limited number of students in the nurse’s office,” she says. “Or maybe only one at any given time.”

The nurse is going to be governed by education and health department standards. Safety protocols such as mask wearing, social distancing if possible, and others will be implemented.

4. Fear of catching COVID-19. Is the fear of catching COVID-19 a reason not to send kids to school? It depends, Desautelle says. “In the context of the district’s obligation to provide FAPE, fear of possible exposure alone does not suffice as a reason why the district must provide instruction in the home. However, it is possible that a student has an underlying medical condition that makes him more susceptible to contracting COVID-19. The second scenario is one that may require a district to consult with the student’s physician.”

5. Remote learning in an in-person district. Synchronous virtual learning could be an ideal accommodation for students who are medically fragile, says Linda Yoder, a school attorney at Shipman, Goodwin LLP in Hartford, Conn. The student would not go into the school building but could sit in front of his computer. The classroom would have cameras on the teacher and the whiteboard, and the student could ask questions and hear his classmates through a platform like Google Meet or Zoom.

The team may tell the parent: “We understand that your child has a medical sensitivity. We’ve had our school physician look at this. It’s an appropriate 504 accommodation if you want to do distance learning even if other students are coming back.”

Florence Simmons covers Section 504, paraprofessionals, and transportation for Special Ed Connection, a DA sister publication.

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